Price Matthew, Malkani Arthur L, Baker Dale
Department of Orthopedic Surgery, University of Louisville, Louisville, Kentucky, USA.
J Arthroplasty. 2009 Sep;24(6):914-7. doi: 10.1016/j.arth.2008.05.007. Epub 2008 Jul 31.
Chronic patella component dislocation after primary knee arthroplasty can be a challenging problem. The purpose of this case series was to review our results of a chronic patella dislocation after total knee arthroplasty treated with a Fulkerson procedure (anteromedialization of the tibial tubercle). Five patients with an average age of 68.8 years (range, 60-76 years) underwent a Fulkerson procedure to restore extensor mechanism alignment. The tibial tubercle osteotomy was secured with lag screws with an average medialization of approximately 1.5 cm. The average preoperative Knee Society score was 70.5 points that improved to 85 points postoperatively. The average knee flexion was 93 degrees preoperatively that improved to 101 degrees postoperatively. Adequate patellofemoral alignment was achieved in all patients along with union of the tibial tubercle osteotomy site. The Fulkerson procedure appears to be an excellent treatment option in patients with a chronically dislocated patella component after total knee arthroplasty.
初次膝关节置换术后慢性髌骨组件脱位可能是一个具有挑战性的问题。本病例系列的目的是回顾我们对采用Fulkerson手术（胫骨结节内移术）治疗全膝关节置换术后慢性髌骨脱位的结果。5例平均年龄68.8岁（范围60 - 76岁）的患者接受了Fulkerson手术以恢复伸膝装置对线。胫骨结节截骨用拉力螺钉固定，平均内移约1.5 cm。术前膝关节协会平均评分为70.5分，术后提高到85分。术前平均膝关节屈曲度为93°，术后提高到101°。所有患者均实现了髌股关节对线良好，胫骨结节截骨部位愈合。Fulkerson手术似乎是全膝关节置换术后慢性髌骨组件脱位患者的一种极佳治疗选择。
